Hospital waiting lists and times have become the public measure of government success or failure. This research examined existing hospital outpatient capacity and considered the age-old problem of patients who fail to attend their appointment. A reduction in did-not-attend (DNA) rates would maximize utilization of capacity, ensure early diagnosis and drive down waiting times. The research was designed to determine whether the introduction of outpatient letters, which included the need for positive confirmation of attendance, decreased the incidence of patient non-attendance. Utilizing an experimental design, data gathered at two Plastic Surgery clinics were compared over two three-month periods, pre- and post-implementation. Total attendance and non-attendance were examined in terms of new and review patients, gender and age profile. The research concludes that the intervention tested in this form can now be discounted thus allowing the exploration of subtler solutions.